Study Objectives: Robotic pets or companion robots have demonstrated positive effects on several emotional and physiological factors in humans. Robots could constitute a complementary or alternative method to treat sleep problems, but individual studies on robots' effectiveness regarding sleep show mixed results. The aim of the current study was to compare the effects of robots, plush toys, and treatment as usual on sleep in adults. Methods: The current study is a systematic review and frequentist network meta-analysis of all randomized and cluster randomized controlled trials comparing the effects of robots, plush toys, and treatment as usual on total sleep time in adults. Results: Four studies were included in the analysis. Three studies were considered to have a high risk of bias, whereas one was rated with some concerns. The studies comprised 381 participants. These participants were older adults, with or without dementia, living in nursing homes. The total sleep time was the only common sleep measure included in all 4 studies. The network meta-analysis showed no statistically significant differences between the 3 experimental groups. Conclusions: The robot interventions were not found to have positive effects on total sleep time in older adults compared with plush toys or treatment as usual. Future studies should use robots especially made to target sleep, include a thorough screening of the participants, and exclude people with adequate sleep, select appropriate sleep measures, and report the results appropriately for future meta-analyses.

The Somnox sleep robot is promoted as sleep enhancing. The currentstudy investigated individual effects, the acceptability and the safety of, andexperiences with, a 3-week intervention in adults with insomnia. A repeatedABA single-case design (n = 4) was used to evaluate the effects of the sleeprobot compared with baseline, as measured with a sleep diary and actigraphy.Pre-, post-, and 1-month follow-up assessments were conducted, measuringsymptoms of insomnia, level of somatic arousal, and symptoms of depressionand anxiety. Questions about adherence were included in the sleep diary.Individual interviews were conducted post intervention to explore theparticipants’ experiences with the sleep robot. The sleep diary and actigraphydata showed marginal differences, and if something, often a slight deteriorationin the intervention phase. Three participants reported improvements regardingtheir sleep in the interviews compared with baseline, which mirrored theresults on the questionnaires (insomnia and arousal) for two of the participants.The same three participants adhered to the intervention. Stable or improvedself-assessed symptoms of depression and anxiety, and information fromthe individual interviews, suggest that the intervention is safe for adults withinsomnia. The results regarding the effects of the sleep robot were mixed, andought to be scrutinized in larger studies before confident recommendationscan be made. However, the study supports the acceptability and safety of theintervention in adults with insomnia.

Insomnia is a common sleep disorder characterized by difficulties initiating sleep, maintaining sleep and/or early-morning awakenings. Hyperarousal is a common causal and maintaining factor in insomnia models. Different techniques to decrease arousal have shown to be effective. Calm breathing can be one approach to enhance sleep. The Somnox sleep robot looks like a bean-shaped cushion to hug, and it gives physical and auditive guidance to calm down the users' breathing. There is currently no impartial empirical evidence of the sleep robot's effects on insomnia. This study is a randomized waitlist-controlled trial with a recruitment target of a minimum of 44 adults with insomnia and sleep disturbing arousal. Participants will complete pre-, mid- and post-intervention assessments, in addition to a 1-month follow-up. The primary outcome measure is the Insomnia Severity Index. Secondary sleep outcome measures are the Pre-Sleep Arousal Scale, a sleep diary and actigraphy. A secondary comorbid symptoms outcome measure is the Hospital Anxiety and Depression Scale. The main research question is whether treated participants have greater improvements regarding symptoms of insomnia post-intervention, compared with the waitlist control group. The analytic approach will be mixed-effects models. The current study will increase the knowledge on breath guidance as a way to reduce hyperarousal and enhance sleep. The sleep robot is a novel method and a potential treatment option for people with insomnia, when the recommended first-line treatments of Cognitive Behavioral Therapy and pharmaceuticals are inaccessible or undesirable. The ethics of healthcare robotics is discussed.

Introduction: The study aimed to explore characteristics of responders to a sleep robot intervention for adults with insomnia, and the likelihood that participants responded to the intervention. Methods: Data from the intervention and the control group in a randomized waitlist-controlled trial (n = 44) were pooled together after both had undergone the intervention. A repeated measures ANOVA and Friedman tests were used to explore changes over time. Differences in baseline characteristics between responders (n = 13), defined as a reduction of -5 on the Insomnia Severity Index from pre- to post-intervention, and non-responders (n = 31) were analyzed with t-tests and chi-square tests. Finally, logistic regression models were estimated.Results: Baseline anxiety was the only statistically significant difference between responders and non-responders (p = 0.03). A logistic regression model with anxiety and sleep quality as predictors was statistically significant, correctly classifying 83.3% of cases. Discussion: The results imply that people with lower anxiety and higher sleep quality at baseline are more likely to report clinically significant improvements in insomnia from the sleep robot intervention.

OBJECTIVE: To investigate individual effects of a three-week sleep robot intervention in adults with ADHD and insomnia, and to explore participants’ experiences with the intervention. METHODS: A proof-of-concept study with a mixed-methods design (n = 6, female = 4) where a repeated ABA single-case study was combined with interviews. Data were collected with the Consensus Sleep Diary, wrist actigraphy, questionnaires on symptoms of insomnia, arousal, emotional distress, and ADHD, and through individual interviews. RESULTS: Visual analysis of the sleep diary and actigraphy variables did not support any effects from the robot intervention. Half of participants reported clinically relevant reductions on the Insomnia Severity Index from pre- to post-intervention. No changes regarding ADHD or arousal. Thematic analysis of the interviews resulted in three themes: (1) A pleasant companion, (2) Too much/not enough, and (3) A new routine. CONCLUSION: Adjustments of the intervention ought to be made to match the needs of patients with both ADHD and insomnia before the next trial is conducted.